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General NPI Number Information
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NPI Number | 1902130644
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Entity Type | Organization
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Legal Business Name | PROACTIVE HEALTHCARE GROUP INC.
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Dates
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Enumeration Date | 09/29/2009
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Last Update Date | 09/29/2009
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Provider Practice Location Address
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Address Line | 9896 BISSONNET ST STE. 210
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City | HOUSTON
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State | TX
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Zip | 77036-8104
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Country | US
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Telephone | 713-988-9700
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Fax | 713-988-9702
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Provider Business Mailing Address
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Address Line | 9896 BISSONNET ST STE. 210
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City | HOUSTON
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State | TX
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Zip | 77036
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Country | US
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Telephone | 713-988-9700
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Fax | 713-988-9702
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MARGARET ARISE
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Credential | RN
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Telephone | 713-988-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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